Moral Agency on the Haitian-Dominican Border--December 2015
Refugee Camp–Anse-a-Pitres (Photo by John Carroll)
During the early part of the nineteenth century in England a cholera outbreak occurred killing many people. The cause of cholera was unknown.
However a young English general practitioner, Thomas Latta, MD, wrote a series of letters to the Lancet describing how he used intravenous fluid in the 1830’s to resuscitate patients near death during the cholera outbreak. This was the first recorded use of intravenous fluid solution for human treatment.
Isn’t it amazing that even though the main treatment for cholera has not changed during the last two hundred years, Haitian patients today in 2015 may not have access to this life saving treatment?
With the conditions that I witnessed in the refugee camps in Anse-a-Pitres, it was not hard to predict that cholera could hit the camps and that an adequate medical response was probably not going to happen. I saw people in the camps drinking untreated water straight from the river reservoir. And I saw no preparations being made to develop and sustain an adequate Cholera Treatment Center (CTC) in Anse-a-Pitres.
During the last six weeks cholera HAS hit the camps in Anse-a-Pitres. And cholera is crossing the border into the Dominican Republic once again.
Haitian doctors and nurses on the Haitian-Dominican border have recently complained that they do not have enough IV fluid to treat their cholera patients. And their patients are dying.
A liter of intravenous Ringer’s Lactate in the United States costs $1 US. And as Dr. Latta proved it is a life saving solution for cholera patients. (IV solution that is shipped to Haiti from other places in the world is most likely much cheaper…but I don’t have the figures.)
When people in refugee camps are not recognized as even existing by the Haitian government, then no action is taken to help these refugees. And the Dominican government could care less about the tens of thousands of people in the border camps unless diseases from these wretched sites spread back to the Dominican Republic.
“Each physician is a moral agent with specific duties and accountability to individual patients, no single physician can be expected to fulfill the full complement of obligations belonging to the medical profession as a moral community.” (Annals of Internal Medicine, 15 December 2015)
The Haitian doctors and nurses need support caring for their patients up and down the Haitian-Dominican border. Most importantly their voices need to be heard and not suppressed as they advocate for these displaced people who have no voice at all.
John A. Carroll, MD
www.haitianhearts.org
Hi John,
I am Alissa, an anthropologist who works in Arcahaie though I am currently finishing my dissertation in Gainesville FL. I ran across this article on cholera fluids while running through my daily news, and I’ll be citing it in my diss.
From 2011-2014 IV fluids were something of a myth where I lived (a small village outside of Arcahaie) and there was real irresponsibility on the part of agencies like USAID who couldn’t even provide rehydration salts and would send me, villagers, infants away with prescriptions for serum that were worthless in town pharmacies which had none, even if people were able to pay. Many people died and it was a total and disheartening mess. Really glad to see someone writing on this. Keep up your tremendous work and your empathetic perspective!